Latest & greatest articles for sedation

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Top results for sedation

1. Anaesthesia and sedation in breastfeeding women

Anaesthesia and sedation in breastfeeding women Guidelines Anaesthesia and sedation in breastfeeding women 2020 June 2020Guidelines Guidelineonanaesthesiaandsedationinbreastfeeding women2020 GuidelinefromtheAssociationofAnaesthetists J.Mitchell, 1 W.Jones, 2 E.Winkley 3 andS.M.Kinsella 4 1Consultant,DepartmentofAnaesthesia,UniversityHospitalAyr,Ayr,UK 2SpecialistPharmacist,BreastfeedingandMedication,Portsmouth,UK 3Consultant,DepartmentofAnaesthesia,NorthumbriaNHSFoundationTrust,UK 4Consultant (...) ,DepartmentofAnaesthesia,StMichael’sHospital,Bristol,UK Summary Breastfeedinghasmanyhealthbene?tsforthemotherandinfant.Womenwhoarebreastfeedingmayrequire anaesthesia or sedation. Concerns regarding the passage of drugs into breast milk may lead to inconsistent advicefromprofessionals.Thiscansometimesresultintheinterruptionoffeedingfor24 hoursorlongerafter anaesthesia, or expressing and discarding (‘pumping and dumping’) breast milk; this may contribute to early cessationofbreastfeeding.However

2020 Association of Anaesthetists of GB and Ireland

2. Remimazolam (Byfavo) - For sedation

Remimazolam (Byfavo) - For sedation Drug Approval Package: BYFAVO U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: BYFAVO Company: Cosmo Technologies, Ltd. Application Number: 212295 Approval Date: 07/02/2020 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF

2020 FDA - Drug Approval Package

3. Capnography for Moderate Sedation in Non-Anesthesia Settings

Capnography for Moderate Sedation in Non-Anesthesia Settings Management Briefs eBrief-no172 -- Capnography for Moderate Sedation in Non-Anesthesia Settings Talk to the Veterans Crisis Line now An official website of the United States government Here's how you know The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. The https:// ensures that you're connecting (...) to the official website and that any information you provide is encrypted and sent securely. Search Search the ORD website Button to search HSRD Contact us TTY: 711 × We're here anytime, day or night — 24/7 If you are a Veteran in crisis or concerned about one, connect with our caring, qualified responders for confidential help. Many of them are Veterans themselves. Get more resources at . » » » Management Briefs eBrief-no172 -- Capnography for Moderate Sedation in Non-Anesthesia Settings Health Services

2020 Veterans Affairs - R&D

4. CIRSE Standards of Practice on Analgesia and Sedation for Interventional Radiology in Adults

CIRSE Standards of Practice on Analgesia and Sedation for Interventional Radiology in Adults CIRSE Standards of Practice on Analgesia and Sedation for Interventional Radiology in Adults | SpringerLink Search Search SpringerLink Search CIRSE Standards of Practice on Analgesia and Sedation for Interventional Radiology in Adults , , , , , , , , & ( 2020 ) 136 Accesses Abstract This CIRSE Standards of Practice document provides best practices for the safe administration of procedural sedation (...) and analgesia for interventional radiology procedures in adults. The document is aimed at health professionals involved in the provision of sedation and analgesia during interventional radiology procedures. The document has been developed by a writing group consisting of physicians with internationally recognised expertise in interventional radiology, and analgesia and sedation. This is a preview of subscription content, to check access. Access options References 1. Green SM, Krauss B. Procedural sedation

2020 Cardiovascular and Interventional Radiological Society of Europe

5. Evidence Brief: Capnography for Moderate Sedation in Non-Anesthesia Settings

Evidence Brief: Capnography for Moderate Sedation in Non-Anesthesia Settings ? June 2020 Evidence Brief: Capnography for Moderate Sedation in Non-Anesthesia Settings Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Authors: Stephanie Veazie, MPH Kathryn Vela (...) , MLIS Katherine Mackey, MD, MPP Evidence Synthesis Program Evidence Brief: Capnography for Moderate Sedation Evidence Synthesis Program i PREFACE The VA Evidence Synthesis Program (ESP) was established in 2007 to provide timely and accurate syntheses of targeted healthcare topics of importance to clinicians, managers, and policymakers as they work to improve the health and healthcare of Veterans. These reports help: • Develop clinical policies informed by evidence; • Implement effective services

2020 Veterans Affairs Evidence-based Synthesis Program Reports

6. COVID-19: Sedation-Ventilation Liberation of COVID Patients

COVID-19: Sedation-Ventilation Liberation of COVID Patients COVID-19: SEDATION-VENTILATION LIBERATION OF COVID+ PATIENTS A Rapid Guidance Summary from the Penn Medicine Center for Evidence-based Practice Last updated May 6, 2020 12:00 pm All links rechecked April 27 th unless otherwise noted. Key questions answered in this summary • How should sedatives be dosed? • What fluid resuscitation approach should be taken with ventilated patients? • How often should spontaneous breathing tests (...) be attempted? • What are the criteria to begin a spontaneous breathing test? • What is the protocol for a spontaneous breathing test? Summary of major recommendations • Minimizing continuous sedation and instead favoring bolused sedation to targeted endpoints reduces number of days of mechanical ventilation. • Patients with ARDS should receive minimal fluid resuscitation. • Ventilator weaning tests should be attempted daily upon improvement of respiratory status. • Ventilator weaning protocol should follow

2020 Centre for Evidence-Based Practice, Penn Medicine

7. Is ketamine sedation without local anesthesia sufficient for pediatric laceration repair? A double-blind randomized clinical trial

Is ketamine sedation without local anesthesia sufficient for pediatric laceration repair? A double-blind randomized clinical trial Is Ketamine Sedation Without Local Anesthesia Sufficient for Pediatric Laceration Repair? A Double-Blind Randomized Clinical Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes (...) Share Permalink Copy Page navigation Am J Emerg Med Actions . 2020 Mar 19;S0735-6757(20)30172-8. doi: 10.1016/j.ajem.2020.03.030. Online ahead of print. Is Ketamine Sedation Without Local Anesthesia Sufficient for Pediatric Laceration Repair? A Double-Blind Randomized Clinical Trial , , , Affiliations Expand Affiliations 1 Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. 2 Department of Emergency Medicine, Seoul National University Bundang

2020 EvidenceUpdates

8. Ketamine Procedural Sedation for Children in EDs

Ketamine Procedural Sedation for Children in EDs The Royal College of Emergency Medicine Best Practice Guideline KETAMINE PROCEDURAL SEDATION FOR CHILDREN IN THE EMERGENCY DEPARTMENT Revised: February 2020 Ketamine Procedural Sedation for Children in The Emergency Department (Feb 2020) 15 Summary of recommendations 1. Ketamine sedation may be appropriate for a procedure that is painful, or frightening after all other options have been considered. 2. Ketamine should not be used for sedation (...) in the Emergency Department for children under the age of 1 year. Ketamine should be only be used by clinicians with significant relevant experience in the use of ketamine when performing procedural sedation in children aged between 2-5 years. 3. Ketamine sedation should take place in an area with full resuscitation facilities immediately available. 4. Safe sedation requires adequate senior medical and nursing cover in the Emergency Department when any sedation takes place. 5. Ketamine sedation requires

2020 Royal College of Emergency Medicine

9. Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients. (Abstract)

Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients. In critically ill, mechanically ventilated patients, daily interruption of sedation has been shown to reduce the time on ventilation and the length of stay in the intensive care unit (ICU). Data on whether a plan of no sedation, as compared with a plan of light sedation, has an effect on mortality are lacking.In a multicenter, randomized, controlled trial, we assigned, in a 1:1 ratio, mechanically ventilated ICU (...) patients to a plan of no sedation (nonsedation group) or to a plan of light sedation (i.e., to a level at which the patient was arousable, defined as a score of -2 to -3 on the Richmond Agitation and Sedation Scale [RASS], on which scores range from -5 [unresponsive] to +4 [combative]) (sedation group) with daily interruption. The primary outcome was mortality at 90 days. Secondary outcomes were the number of major thromboembolic events, the number of days free from coma or delirium, acute kidney

2020 NEJM

10. Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial (Abstract)

Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol.Forty (...) -eight patients were enrolled and randomly assigned to either a dexmedetomidine group (n = 24), which received a loading dose of 1 μg/kg dexmedetomidine over 10 minutes, followed by a continuous infusion of 0.1-0.5 μg·kg·hour, or a propofol group (n = 24), which received a continuous infusion of propofol via a target-controlled infusion to maintain the effect-site concentration within a range of 0.5-2.0 μg/mL. The drug infusion rate was determined according to the sedation level, targeting a modified

2020 EvidenceUpdates

11. Impact of Timing of Preprocedural Opioids on Adverse Events in Procedural Sedation (Abstract)

Impact of Timing of Preprocedural Opioids on Adverse Events in Procedural Sedation The risk of respiratory depression is increased when opioids are added to sedative agents. In our recent multicenter emergency department (ED) procedural sedation cohort, we reported a strong association between preprocedural opioids and sedation-related adverse events. We sought to examine the association between timing of opioids and the incidence of adverse sedation outcomes.We conducted a secondary analysis (...) of a prospective cohort of children aged 0 to 18 years who received sedation for a painful procedure in six Canadian pediatric EDs from July 2010 to February 2015. The primary risk factor was timing of opioid administration, adjusted for age, opioid type, preprocedural and sedation medications, and procedure type. Outcomes were 1) oxygen desaturation, 2) vomiting, and 3) positive pressure ventilation (PPV).Of the 6,295 children in the original cohort, 1,806 (29%) received a preprocedural opioid. Patients

2020 EvidenceUpdates

12. Oral Ondansetron to Reduce Vomiting in Children Receiving Intranasal Fentanyl and Inhaled Nitrous Oxide for Procedural Sedation and Analgesia: A Randomized Controlled Trial (Abstract)

Oral Ondansetron to Reduce Vomiting in Children Receiving Intranasal Fentanyl and Inhaled Nitrous Oxide for Procedural Sedation and Analgesia: A Randomized Controlled Trial Intranasal fentanyl and inhaled nitrous oxide are increasingly combined to provide procedural sedation and analgesia in the pediatric emergency setting. This regimen is attractive because of its nonparenteral administration, but is associated with a higher incidence of vomiting than nitrous oxide alone. We seek to assess (...) whether prophylactic oral ondansetron use could reduce the incidence of vomiting associated with intranasal fentanyl and nitrous oxide for procedural sedation compared with placebo.This was a double-blind, randomized controlled trial of oral ondansetron versus placebo conducted at a single tertiary care pediatric emergency department. Children aged 3 to 18 years with planned sedation with intranasal fentanyl and nitrous oxide were randomized to receive oral ondansetron or placebo 30 to 60 minutes

2020 EvidenceUpdates

13. During Conscious Sedation the Risk of Adverse Events Is Likely Increased in Obese Children Compared to Those of Healthy Weight

During Conscious Sedation the Risk of Adverse Events Is Likely Increased in Obese Children Compared to Those of Healthy Weight UTCAT3394, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title During Conscious Sedation the Risk of Adverse Events Is Likely Increased in Obese Children Compared to Those of Healthy Weight Clinical Question Are obese children undergoing conscious sedation at increased risk for adverse events (...) compared to children who are at healthy weight? Clinical Bottom Line For children with childhood obesity, conscious sedation may lead to more adverse events including oxyhemoglobin desaturation, nausea and true apnea. However, additional evidence is needed to know if there is any clinical and statistical difference between obese children and healthy weight children during conscious sedation. This is supported by both a cross-sectional retrospective study and a review of literature on the relationship

2019 UTHSCSA Dental School CAT Library

14. Early Sedation with Dexmedetomidine in Critically Ill Patients. Full Text available with Trip Pro

Early Sedation with Dexmedetomidine in Critically Ill Patients. Dexmedetomidine produces sedation while maintaining a degree of arousability and may reduce the duration of mechanical ventilation and delirium among patients in the intensive care unit (ICU). The use of dexmedetomidine as the sole or primary sedative agent in patients undergoing mechanical ventilation has not been extensively studied.In an open-label, randomized trial, we enrolled critically ill adults who had been undergoing (...) ventilation for less than 12 hours in the ICU and were expected to continue to receive ventilatory support for longer than the next calendar day to receive dexmedetomidine as the sole or primary sedative or to receive usual care (propofol, midazolam, or other sedatives). The target range of sedation-scores on the Richmond Agitation and Sedation Scale (which is scored from -5 [unresponsive] to +4 [combative]) was -2 to +1 (lightly sedated to restless). The primary outcome was the rate of death from any

2019 NEJM Controlled trial quality: predicted high

15. Is the Level of Sedation Depth in the Early Postintubation Period Associated With Worse Patient Outcomes? Full Text available with Trip Pro

Is the Level of Sedation Depth in the Early Postintubation Period Associated With Worse Patient Outcomes? Is the Level of Sedation Depth in the Early Postintubation Period Associated With Worse Patient Outcomes? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages 488–490 Is the Level of Sedation Depth in the Early Postintubation Period Associated With Worse Patient Outcomes? x Michael (...) Gottlieb , MD (EBEM Commentator) , x Keya A. Patel , MD (EBEM Commentator) , x William G. McDowell , MD (EBEM Commentator) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: | Publication History Published online: December 20, 2018 Expand all Collapse all Article Outline Take-Home Message Compared with deep sedation, light sedation early in the postintubation course is associated with reduced mortality, decreased length of ICU stay, and fewer days of mechanical

2019 Annals of Emergency Medicine Systematic Review Snapshots

16. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures | From the American Academy of Pediatrics | Pediatrics '); document.write(''); } function OAS_AD(pos) { if (OAS_version >= 11 && typeof(OAS_RICH)!='undefined') { OAS_RICH(pos); } else { OAS_NORMAL(pos); } } //--> Search (...) for this keyword Source User menu Sections Sign up for highlighting editor-chosen studies with the greatest impact on clinical care. From the American Academy of Pediatrics Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures Charles J. Coté , Stephen Wilson , AMERICAN ACADEMY OF PEDIATRICS , AMERICAN ACADEMY OF PEDIATRIC DENTISTRY Abstract The safe sedation of children for procedures requires a systematic approach

2019 American Academy of Pediatrics

17. Dexmedetomidine (Dexdor) - Sedation of non-intubated adult patients prior to and/or during diagnostic or surgical procedures requiring sedation

Dexmedetomidine (Dexdor) - Sedation of non-intubated adult patients prior to and/or during diagnostic or surgical procedures requiring sedation Published 11 February 2019 Statement of advice SMC2161 dexmedetomidine 100 micrograms/ml concentrate for solution for infusion (Dexdor®) Orion Pharma UK Limited 11 January 2019 ADVICE: in the absence of a submission from the holder of the marketing authorisation dexmedetomidine (Dexdor®) is not recommended for use within NHSScotland. Indication under (...) review: Sedation of non-intubated adult patients prior to and/or during diagnostic or surgical procedures requiring sedation, i.e. procedural/awake sedation. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this indication. As a result we cannot recommend its use within NHSScotland. Advice context: No part of this advice may be used without the whole of the advice being quoted in full. This advice represents the view of the Scottish Medicines

2019 Scottish Medicines Consortium

18. Clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care unit: A Rapid Review

Clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care unit: A Rapid Review ICU pain, agitation, delirium, sedation and mobilisation CPGs: A Rapid Review 1 Clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care unit: A Rapid Review Citation Corey Joseph & Angela Melder. April 2018. Clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care (...) unit: A Rapid Review. Centre for Clinical Effectiveness, Monash Health, Melbourne, Australia. Contact cce@monashhealth.org Executive Summary Background The Program Medical Director for Critical Care has requested a review of clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care unit (ICU) to inform future implementation of a new clinical practice guideline in the ICU. Objectives The objective of this review was to review and summarise current

2019 Monash Health Evidence Reviews

19. Premedication With Midazolam or Haloperidol to Prevent Recovery Agitation in Adults Undergoing Procedural Sedation With Ketamine: A Randomized Double-Blind Clinical Trial (Abstract)

Premedication With Midazolam or Haloperidol to Prevent Recovery Agitation in Adults Undergoing Procedural Sedation With Ketamine: A Randomized Double-Blind Clinical Trial We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time.We randomized emergency department patients older than 18 years who needed procedural sedation to receive (...) 1 of the following 3 interventions in double-blind fashion 5 minutes before receiving intravenous ketamine at 1 mg/kg: intravenous distilled water, intravenous midazolam at 0.05 mg/kg, or intravenous haloperidol at 5 mg. Our main study outcomes were recovery agitation as assessed by the maximum observed Pittsburgh Agitation Scale score and by the Richmond Agitation-Sedation Scale score at 5, 15, and 30 minutes after ketamine administration. Our secondary outcomes were clinician satisfaction

2019 EvidenceUpdates

20. Safety and Efficacy of Remimazolam Compared With Placebo and Midazolam for Moderate Sedation During Bronchoscopy (Abstract)

Safety and Efficacy of Remimazolam Compared With Placebo and Midazolam for Moderate Sedation During Bronchoscopy While the complexity of flexible bronchoscopy has increased, standard options for moderate sedation medications have not changed in three decades. There is a need to improve moderate sedation while maintaining safety. Remimazolam was developed to address shortcomings of current sedation strategies.A prospective, double-blind, randomized, multicenter, parallel group trial (...) was performed at 30 US sites. The efficacy and safety of remimazolam for sedation during flexible bronchoscopy were compared with placebo and open-label midazolam.The success rates were 80.6% in the remimazolam arm, 4.8% in the placebo arm (P < .0001), and 32.9% in the midazolam arm. Bronchoscopy was started sooner in the remimazolam arm (mean, 6.4 ± 5.82 min) compared with placebo (17.2 ± 4.15 min; P < .0001) and midazolam (16.3 ± 8.60 min). Time to full alertness after the end of bronchoscopy

2019 EvidenceUpdates